The association between HIV/AIDS-related knowledge and perception of risk for infection: a systematic review

Kabwama, Steven Ndugwa; Berg‐Beckhoff, Gabriele

doi:10.1177/1757913915595831

Cited by 38 publications

(17 citation statements)

References 66 publications

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“…A small literature illustrates contexts where average HIV risk perceptions are at odds with actual disease prevalence [11, 12], and therefore suggests inaccuracies in self-perceived HIV risk. Potential drivers of inaccurate risk perceptions may include an incomplete consideration of the riskiness of sexual behaviors or the influence of factors outside of direct HIV risk factors [11, 13–18]. However, no single study has systematically examined the influence of these diverse factors.…”

Section: Introductionmentioning

confidence: 99%

Accuracy and determinants of perceived HIV risk among young women in South Africa

Maughan-Brown

Venkataramani

2017

BMC Public Health

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BackgroundHIV risk perceptions are a key determinant of HIV testing. The success of efforts to achieve an AIDS-free generation – including reaching the UNAIDS 90–90-90 target – thus depends critically on the content of these perceptions. We examined the accuracy of HIV-risk perceptions and their correlates among young black women in South Africa, a group with one of the highest HIV incidence rates worldwide.MethodsWe used individual-level longitudinal data from the Cape Area Panel Study (CAPS) from 2005 to 2009 on black African women (20–30 years old in 2009) to assess the association between perceived HIV-risk in 2005 and the probability of testing HIV-positive four years later. We then estimated multivariable logistic regressions using cross-sectional data from the 2009 CAPS wave to assess the relationship between risk perceptions and a wide range of demographic, sexual behaviour and psychosocial covariates of perceived HIV-risk.ResultsWe found that the proportion testing HIV-positive in 2009 was almost identical across perceived risk categories in 2005 (no, small, moderate, great) (χ 2 = 1.43, p = 0.85). Consistent with epidemiologic risk factors, the likelihood of reporting moderate or great HIV-risk perceptions was associated with condom-use (aOR: 0.57; 95% CI: 0.36, 0.89; p < 0.01); having ≥3 lifetime partners (aOR: 2.38, 95% CI: 1.53, 3.73; p < 0.01); knowledge of one’s partner’s HIV status (aOR: 0.67; 95% CI: 0.43, 1.07; p = 0.09); and being in an age-disparate partnerships (aOR: 1.73; 95% CI: 1.09, 2.76; p = 0.02). However, the likelihood of reporting moderate or great self-perceived risk did not vary with sexually transmitted disease history and respondent age, both strong predictors of HIV risk in the study setting. Risk perceptions were associated with stigmatising attitudes (aOR: 0.53; 95% CI: 0.26, 1.09; p = 0.09); prior HIV testing (aOR: 0.21; 95% CI: 0.13, 0.35; p < 0.01); and having heard that male circumcision is protective (aOR: 0.38; 95% CI: 0.22, 0.64; p < 0.01).ConclusionsResults indicate that HIV-risk perceptions are inaccurate. Our findings suggest that this inaccuracy stems from HIV-risk perceptions being driven by an incomplete understanding of epidemiological risk and being influenced by a range of psycho-social factors not directly related to sexual behaviour. Consequently, new interventions are needed to align perceived and actual HIV risk.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4593-0) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Accuracy and determinants of perceived HIV risk among young women in South Africa

Maughan-Brown

Venkataramani

2017

BMC Public Health

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“…However, this makes it challenging to distinguish individuals who actually have high likelihood of HIV infection apart from all those who perceived themselves as having low risk. While the knowledge of HIV/AIDS may facilitate accurate self‐risk assessment, our finding supported previous systematic review, which did not find this association . This could be that people cannot perceive the risk when they have not much knowledge, and an increase in knowledge to a certain point may improve risk perception; however, further increase in knowledge may reduce risk perception, because knowledge may produce biases in judgment, such as optimistic bias, psychological distancing and overconfidence, leading to inaccurate risk perception .…”

Section: Discussionmentioning

confidence: 99%

Discordance between self‐perceived and actual risk of HIV infection among men who have sex with men and transgender women in Thailand: a cross‐sectional assessment

et al. 2019

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Introduction Low uptake of HIV testing and services, including pre‐exposure prophylaxis (PrEP), in Thai men who have sex with men (MSM) and transgender women (TGW) may be due to the inaccuracy in self‐risk assessment. This study investigated the discordance between self‐perceived HIV risk and actual risk. Methods Data were obtained between May 2015 and October 2016 from MSM and TGW enrolled in key population‐led Test and Treat study in six community health centres in Thailand. Eligible participants were at least 18 years old, Thai national, had sex with men, had unprotected sex with a man in the past six months or had at least three male sex partners in the past six months, and were not known to be HIV positive. Baseline demographic behavioural characteristics questionnaires, including self‐perceived HIV risk, were self‐administered. Participants received HIV/STI (syphilis/gonorrhoea/chlamydia) testing at baseline. Participants who self‐perceived to have low risk, but engaged in HIV‐susceptible practices were categorized as having risk discordance (RD). Regression was conducted to assess factors associated with RD among MSM and TGW separately. Results Of the 882 MSM and 406 TGW participants who perceived themselves as having low HIV risk, over 80% reported at least one of the following: tested HIV positive, engaged in condomless sex, tested positive for a sexually transmitted infection sexually transmitted infection (STI; or used amphetamine‐type stimulants. Logistic regression found that living with a male partner (p = 0.005), having never tested for HIV (p = 0.045), and living in Bangkok (p = 0.01) and Chiang Mai (p < 0.001) were associated with increased risk discordance among MSM. Living with a male partner (p = 0.002), being less than 17 years old at sexual debut (p = 0.001), and having a low knowledge score about HIV transmission (p < 0.001) were associated with increased risk discordance among TGW. However, for TGW, being a sex worker decreased the chance of risk discordance (p = 0.034). Conclusions Future HIV prevention messages need to fill in the gap between self‐perceived risk and actual risk in order to help HIV‐vulnerable populations understand their risk better and proactively seek HIV prevention services.

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“…This may be explained by the belief that associates HIV risk with particular risk-recognized groups, i.e., MSM, injecting drug users and commercial sex workers rather than their risk behaviors [ 5 , 14 , 15 ]. The underlying mechanisms for false perception of low HIV risk among the students despite the high level of knowledge may include their risk assessment in light of remote or past low-risk behaviors despite current high-risk behaviors, optimistic bias that the risk behaviors they engaged in were at no or low-risk, denial or suppression mechanism and bias that they did not use facts in their judgment about risk perception but used certain cues inherent in the questions asked [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Uptake of HIV testing and counseling, risk perception and linkage to HIV care among Thai university students

2016

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BackgroundHIV testing and counseling (HTC) with linkage to care after known infection are key components for HIV transmission prevention. This study was conducted to assess HTC uptake, HIV risk perception and linkage to care among Thai university students.MethodsAn outreach HTC program was conducted in a large public university in Thailand from January 2013 to December 2014. The program consisted of brief HIV knowledge assessment, free HTC, HIV risk assessment and education provided by the healthcare personnel. Students were categorized into low, moderate and high-risk groups according to the pre-defined HIV risk characteristics.ResultsOne-thousand-eight-hundred-one students participated in the program, 494 (27 %) underwent HTC. Independent characteristics associated with no HTC uptake included female sex (P < 0.001), lower HIV knowledge score (P < 0.001), younger age (P < 0.001) and students from non-health science faculties (P = 0.02). Among the 494 students undergoing HTC, 141 (29 %) were categorized into moderate or high-risk group, of whom 45/141 (32 %) had false perception of low HIV risk. Being heterosexual was independently associated with false perception of low HIV risk (P = 0.04). The rate of new HIV infection diagnosis was 4/494 (0.8 %). Of these 4 HIV-infected students, 3 (75 %) were men who have sex with men and only 2 of the 4 students (50 %) showed up for HIV continuity care.ConclusionsAn outreach HIV prevention program with HTC was feasible and beneficial in detecting HIV risk and infection among the university students. However, interventions to improve HTC uptake, HIV risk perception and linkage to care are needed.

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The association between HIV/AIDS-related knowledge and perception of risk for infection: a systematic review

Cited by 38 publications

References 66 publications

Accuracy and determinants of perceived HIV risk among young women in South Africa

Accuracy and determinants of perceived HIV risk among young women in South Africa

Discordance between self‐perceived and actual risk of HIV infection among men who have sex with men and transgender women in Thailand: a cross‐sectional assessment

Uptake of HIV testing and counseling, risk perception and linkage to HIV care among Thai university students

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